Individual provider Active NPI

Daniel R Miller, PAC

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1487922159
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4922 Issued in AZ
Practice address
18444 N 25TH Ave
Suite 210
Phoenix, AZ 85023-1261
Phone
(623) 537-5600
Fax
(866) 939-2673
NPI assigned
Dec 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4922 AZ
Medical Physician Assistant 363AM0700X 4922 AZ
Surgical Physician Assistant 363AS0400X 4922 AZ Primary

Addresses

Primary practice location

18444 N 25TH Ave
Suite 210
Phoenix, AZ 85023-1261

Mailing address

18444 N 25TH Ave
Suite 310
Phoenix, AZ 85023-1261
Phone (623) 537-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000581 AZ Practitioner - Physician Assistant 7618144171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4922AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education, LLC Physician Assistant Past Accepting new patients
Next Level Facility LLC PastSince Nov 12, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1487922159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "SUITE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "SUITE 210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-08",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4922",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4922",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.